Breast reduction and the nipple areola complex

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The position and size of the areola are important considerations when evaluating a patient for a breast reduction. Typically it’s necessary to raise the nipple to a more youthful position. Often the areola is made smaller to achieve optimal proportions with the newly tight and perky breast.

To learn more about breast reduction, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Breast Augmentation: What’s Recovery Like?

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During each breast augmentation operation, a long-acting local anaesthetic is placed around the implant so that patients will feel only minimal discomfort following surgery. Most of my breast augmentation patients take only a few days off from work to recover whilst others take up to a week. Patients may ease back into their normal exercise routine beginning several weeks after surgery.

 

To learn more about breast augmentations, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Breast Augmentation: Where are the Incisions and Implants Located?

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Most plastic surgeons favour the infra-mammary incision location for most breast implants. The peri-areolar incision is made as a semicircle at the lower border of the pigmented areola. It does heal beautifully in most cases and uses the interface of the darker and lighter pigmented skin to camouflage the incision. For patients with small areolae, it may be preferable to use the infra-mammary incision, located underneath the breast. This incision also heals very well, and is especially useful for women with well defined creases under their breasts.

The axillary incision (in the armpit) is another option, but it’s better suited for saline implants than silicone gel. Because this access incision is a greater distance from the implant pocket, it’s less precise than the peri-areolar and infra-mammary approaches. Studies have confirmed that there is a higher implant revision rate using the axillary approach. Usually the axillary scars heal well, but they may still be visible when the patient wears sleeveless outfits. There is also a higher rate of breast implant infections with the peri-areolar and axillary approaches.

Patients frequently ask what effect the incision location has on maintaining nipple sensation after surgery. The answer is that the access incision usually has little effect on nipple sensation. Rather, it’s the size of the implant pocket that has the largest impact on nipple sensation. Large implants may require a pocket that stretches the nerves to the point that they do not function well, increasing the odds of impaired nipple sensation. Even so, the vast majority of my patients maintain normal nipple sensation.

Breast implants may be placed over or under the pectoralis major muscle. In the early days of breast augmentation, all implants were placed on top of the muscle. However, in recent decades, it has become more common to place implants underneath the pectoralis major muscle. The muscle covers the top half of the implant, providing additional thickness of coverage over the implant in the critical cleavage area. This makes it less likely that the implant edges or ripples will be visible when wearing a bra or swimsuit. Studies have also shown that the rate of capsular contracture is lower when the implants are placed under the muscle. Breast imaging to screen for breast cancer is more accurate when the implants are placed behind the muscle. For these reasons, I prefer to place implants underneath the muscle for most of my breast implant patients.

 

To learn more about breast augmentations, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Breast Augmentation: What Are Your Breast Implant Options?

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The two main categories of breast implants are silicone gel or saline-filled implants. Silicone gel implants have been popular since the early 1960s, and they have gone through multiple generations of improvements since that time. Silicone gel implants have undergone rigorous studies which have shown they are safe and do not cause breast cancer nor connective tissue disorders.

The main advantage of silicone implants is that they feel more natural than saline implants. Gel implants are less prone to rippling than saline, which makes them particularly advantageous for thin patients. The current 5th generation of silicone implants are cohesive, meaning that the gel is viscous enough that even if the implant ruptures the gel tends to remain in the same place, a little like jelly. Previous generations, the silicone was more like thick maple syrup.

Saline (ie. saltwater) implants have a long record of safety too and are less expensive than silicone gel implants. They are generally placed when they are empty and filled once they are inside the breast pocket, so that the access incisions may be even smaller. When a saline implant leaks, most of the saline from the implant is rapidly and harmlessly absorbed by the body. The deflation is usually obvious, and the patient returns for removal and replacement of the saline implant. This may be done under local anaesthesia if the patient is an appropriate candidate. The primary disadvantage of saline implants is that they don’t look or feel as natural as the silicone gel implants. This is a particularly important issue for women who are thin or have decreased elasticity of their skin.

 To learn more about breast augmentation, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 
Body Lift: What type of techniques are there?

 

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Body lifts can be performed in two different ways, to treat either the upper or the lower body:

  • Lower body lift: The lower body lift is the most common type of body lift in my practice. It typically includes a tummy tuck (abdominoplasty), thigh lift and buttocks lift performed at the same time. The incision is concealed around the waistline so that it’s not visible when wearing underwear or a bikini.
  • Upper body lift: For patients with severe skin laxity of the upper torso, an upper body lift may be the appropriate treatment. This typically includes a bra line back lift and upper abdominoplasty. The procedure is individualised for the particular patient.

To learn more about body lifts, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Body Lift: What’s the recovery like?

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Patients usually take at least 3-4 weeks off from work following a body lift. I encourage patients to ambulate shortly after surgery. They may resume full exercise approximately 6 weeks following surgery.

To learn more about body lifts, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Abdominoplasty: Who are good candidates?

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Candidates for an abdominoplasty (tummy tuck) have some or all of the following problems:

  1. Loose skin on the lower abdomen
  2. Stretch marks on the lower abdominal
  3. Abdominal muscle laxity
  4. Pubic laxity

Good abdominoplasty candidates should be healthy non-smokers. Avoiding smoking is important to decrease risks. Although it’s better for patients to be near their ideal weight, many patients who are overweight are still good candidates for the procedure.

To learn more about abdominoplasty (tummy tuck), request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Abdominoplasty: What does the procedure involve?

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An abdominoplasty (tummy tuck) procedure involves the following steps:

  1. Removing a large amount of lower abdominal skin (and stretch marks)
  2. Removing a large amount of lower abdominal fat
  3. Tightening the rectus abdominis muscles of the abdomen
  4. Redistributing the upper abdominal skin over the entire abdomen
  5. Creating a new belly button within the tightened abdominal skin
  6. Tightening the pubic area

To learn more about abdominoplasty (tummy tuck), request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

 

Breast reduction: What are the symptoms?

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Breast reduction surgery patients are among the happiest of all plastic surgery patients because they both look better and feel better following surgery. When women have large, burdensome breasts, they frequently suffer from a condition called symptomatic macromastia. Symptomatic macromastia is considered to be a medical problem that may include the following symptoms:

  1. Pain in the neck, shoulders, breasts, and upper or lower back
  2. Bra strap indentations
  3. Rashes underneath the breasts
  4. Finger or hand numbness
  5. Difficultly exercising, fitting into clothing or examining the breasts

To learn more about breast reduction, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Abdominoplasty: Can the Caesarian scar be removed at the same time?

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During pregnancy, skin may be stretched to the point that microscopic fractures form in the skin, or dermis, resulting in stretch marks (also known as striae). Caesarean section scars may accentuate fatty bulges by tethering the skin to the underlying muscles, causing the fat and loose skin to fold over the scar. The rectus abdominis muscles on the abdomen may become separated in the midline, creating a potbelly appearance. Fat also redistributes with age, becoming concentrated in the lower abdomen. The hourglass waistline of youth gives way to a larger midsection. That’s why many women choose abdominoplasty as part of their “Mommy Makeover” and as a bonus the Caesarian scar can be removed at the same time.

Although abdominoplasty (tummy tuck) can achieve dramatic improvements, it’s important to also consider adjacent areas of the body for optimal results. For many patients, liposuction around the waist and thighs will provide more comprehensive results. Mothers will frequently choose breast surgery as well. This combination of procedures completes their transformation back to the hourglass figure they once had.

To learn more about abdominoplasty (tummy tuck), request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au